THE ASSUMPTIONS OF

HEALTH PSYCHOLOGY

By
Prof. Dr. Talat Sohail
THE ASSUMPTIONS OF HEALTH PSYCHOLOGY
Several assumptions central to health
psychology have been highlighted. These
include the following.
 The mind–body split
 Dividing up the soup
 The problem of progression
 The problem of methodology
 The problem of measurement
 Integrating the individual with their social context
 Data are collected in order to develop theories; these theories are not data
 Theories concerning different areas of health psychology are distinct from each
other
 Studying a discipline
 A critical health psychology
THE MIND–BODY SPLIT
Health psychology sets out to provide an integrated model of
the individual by establishing a holistic approach to health.
Therefore it challenges the traditional medical model of the
mind–body split and provides theories and research to
support the notion of a mind and body that are one.
For example, it suggests that beliefs influence behavior, which
in turn influences health; that stress can cause illness and
that pain is a perception rather than a sensation. In addition,
it argues that illness cognitions relate to recovery from
illness and coping relates to longevity. However, does this
approach really represent an integrated individual? Although
all these perspectives and the research that has been
carried out in their support indicate that the mind and the
body interact, they are still defined as separate. The mind
reflects the individuals’ psychological states (i.e. their
beliefs, cognitions, perceptions), which influence but are
separate to their bodies (i.e. the illness, the body, the body’s
systems).
DIVIDING UP THE SOUP
Health psychology describes variables such as beliefs (risk
perception, outcome expectancies, costs and benefits,
intentions, implementation intentions), emotions (fear,
depression, anxiety) and behaviors (smoking, drinking,
eating, screening) as separate and discrete. It then
develops models and theories to examine how these
variables interrelate.
For example, it asks, ‘What beliefs predict smoking?’, ‘What
emotions relate to screening?’ Therefore it separates out
‘the soup’ into discrete entities and then tries to put them
back together. However, perhaps these different beliefs,
emotions and behaviours were not separate until
psychology came along. Is there really a difference between
all the different beliefs? Is the thought ‘I am depressed’ a
cognition or an emotion? When I am sitting quietly thinking,
am I behaving? Health psychology assumes differences and
then looks for association. However, perhaps without the
original separation there would be nothing to associate!
THE PROBLEM OF PROGRESSION
This book has illustrated how theories, such as those relating to
addictions, stress and screening, have changed over time. In
addition, it presents new developments in the areas of social
cognition models and PNI.
For example, early models of stress focused on a simple stimulus–
response approach. Nowadays we focus on appraisal.
Furthermore, nineteenth century models of addiction believed
that it was the fault of the drug. In the early twenty-first century,
we see addiction as being a product of learning. Health
psychology assumes that these shifts in theory represent
improvement in our knowledge about the world. We know more
than we did a hundred years ago and our theories are more
accurate. However, perhaps such changes indicate different, not
better, ways of viewing the world. Perhaps these theories tell us
more about how we see the world now compared with then,
rather than simply that we have got better at seeing the world.
THE PROBLEM OF METHODOLOGY
In health psychology we carry out research to collect data
about the world. We then analyse these data to find out
how the world is, and we assume that our methodologies
are separate to the data we are collecting.
In line with this, if we ask someone about their
implementation intentions it is assumed that they have
such intentions before we ask them.
Further, if we ask someone about their anxieties we assume
that they have an emotion called anxiety, regardless of
whether or not they are talking to us or answering our
questionnaire. However, how do we know that our
methods are separate from the data we collect? How do
we know that these objects of research (beliefs, emotions
and behaviours) exist prior to when we study them?
Perhaps by studying the world we are not objectively
examining what is really going on but are actually
changing and possibly even creating it.
THE PROBLEM OF MEASUREMENT
In line with the problem of methodology is the problem
of measurement. Throughout the different areas of
health psychology, researchers develop research
tools to assess quality of life, pain, stress, beliefs and
behaviours. These tools are then used by the
researchers to examine how the subjects in the
research feel/think/behave.
However, this process involves an enormous leap of
faith – that our measurement tool actually measures
something out there. How do we know this? Perhaps
what the tool measures is simply what the tool
measures. A depression scale may not assess
‘depression’ but only the score on the scale.
Likewise, a quality-of-life scale may not assess quality
of life but simply how someone completes the
questionnaire.
INTEGRATING THE INDIVIDUAL WITH THEIR SOCIAL
CONTEXT
Psychology is traditionally the study of the individual.
Sociology is traditionally the study of the social
context. Recently, however, health psychologists have
made moves to integrate this individual with their
social world. To do this they turn to social
epidemiology (i.e. explore class, gender and
ethnicity), social psychology (i.e. turn to subjective
norms) or social constructionism (i.e. turn to
qualitative methods). Therefore health psychologists
access either the individuals’ location within their
social world via their demographic factors or ask the
individuals for their beliefs about the social world.
DATA ARE COLLECTED IN ORDER TO DEVELOP THEORIES;
THESE THEORIES ARE NOT DATA

Health psychologists collect data and develop theories

about the individual, for example theories about
smoking, eating, stress and pain.
These theories are then used to tell us something
about the world. However, these theories could also
be used as data, and in the same way that we study
the world, we could study our theories about the
world.
Perhaps this would not tell us about the world per se
but about how we see it. Furthermore, changes in
theories could also tell us about the way in which we
see the world has changed. Likewise we could study
our methods and our measurement tools. Do these
also tell us something about the changing psychology
of the past hundred years?
THEORIES CONCERNING DIFFERENT AREAS
OF HEALTH PSYCHOLOGY ARE DISTINCT
FROM EACH OTHER
There are many theories relating to stress,
pain and health behaviours, but has not
examined parallels within these theories.
Perhaps there are patterns within these
different theories that reflect ‘umbrella’
changes within health psychology. Perhaps
also these changes indicate consistent shifts
in the way psychological theory describes the
individual.
STUDYING A DISCIPLINE
Therefore there are many assumptions underlying the
discipline of health psychology. Acknowledging and
understanding these assumptions provides the basis of a
more critical perspective on research.
Findings from research are not taken for granted and
theories can be seen within their inherent limitations.
However, these assumptions themselves provide a basis
for research – research into how a discipline has
changed.
In addition, this kind of research can provide insights into
how the focus of that discipline (the individual) has also
changed. This approach provides a basis for a social
study of a discipline. In the same way that sociologists
study scientists, biographers study authors and literary
theorists study literature, a discipline can also be
studied.
A CRITICAL HEALTH PSYCHOLOGY
Over the past few years a subsection of health
psychology has developed which has become
known as ‘critical health psychology’. Researchers
within this area emphasize the qualitative, critical
and alternative approaches to understanding
health and illness.
Further, they highlight the role of the social context
and the political dimensions to health. Some of
the assumptions addressed in this chapter are
also addressed within the domain of critical health
psychology.